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North Shore Medical Clinic
7450 Meridian Street, Suite 150
Portland, OR 97202
(503) 555-2330
UNDERSTANDING DIABETES
What is diabetes?
Diabetes is a group of diseases characterized by high levels of blood glucose resulting from defects in
insulin production, insulin action, or both. Insulin is a hormone needed to convert sugar, starches, and
other food into energy needed for daily life. The cause of diabetes is a mystery but genetics and
environmental factors such as obesity and lack of exercise appear to play roles. Diabetes can be
associated with serious complications and premature death, but people with diabetes can take steps to
control the disease and lower the risk of complications.
Types of Diabetes
Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset
diabetes. Type 1 diabetes develops when the body’s immune system destroys pancreatic beta cells, the
only cells in the body that make the hormone insulin that regulates blood glucose. This form of diabetes
usually strikes children and young adults, although disease onset can occur at any age, and may account
for 5 to 10 percent of all diagnosed cases of diabetes. Autoimmune, genetic, and environmental factors
are involved in the development of this type of diabetes.
Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset
diabetes and may account for about 90 to 95 percent of all diagnosed cases of diabetes. Risk factors for
type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational
diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity.
Gestational diabetes is a form of glucose intolerance diagnosed in some women during pregnancy.
Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and
Native Americans. It is also more common among obese women and women with a family history of
diabetes. After pregnancy, 5 to 10 percent of women with gestational diabetes are found to have type 2
diabetes. Women who have had gestational diabetes have a 20 to 50 percent chance of developing
diabetes in the following 5- to 10-year period.
Statistics on Diabetes
According to statistics gathered in 2002 and presented by the American Diabetes Association, 18.2
million people in the United States have diabetes. This number constitutes 6.3% of the total population.
Complications of Diabetes
Heart Disease and Stroke
Heart disease is the leading cause of diabetes-related deaths. Adults with diabetes have heart disease
death rates about 2 to 4 times higher than adults without diabetes.
The risk for stroke is 2 to 4 times higher among people with diabetes.
About 65% of deaths among people with diabetes are due to heart disease and stroke.
High Blood Pressure
About 73% of adults with diabetes have blood pressure greater than or equal to 130/80 or use
prescription medications for hypertension.
Blindness
Diabetes is the leading cause of new cases of blindness among adults 20–74 years old.
Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year.
Kidney Disease
Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2002.
In 2002, 44,400 people with diabetes began treatment for end-stage renal disease.
In 2002, 153,730 people with diabetes underwent dialysis or kidney transplantation.
Nervous System Disease
About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage. The
results of such damage include impaired sensation or pain in the feet or hands, slowed digestion of food
in the stomach, carpal tunnel syndrome, and other nerve problems.
Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations.
Amputations
More than 60% of nontraumatic lower-limb amputations in the United States occur among people with
diabetes.
From 2000 to 2001, about 82,000 nontraumatic lower-limb amputations were performed each year
among people with diabetes.
Dental Disease
Periodontal or gum diseases are more common among people with diabetes than among people
without diabetes. Among young adults, those with diabetes are often at twice the risk of those without
diabetes.
Almost one-third of people with diabetes have severe periodontal diseases with loss of attachment of
the gums to the teeth measuring 5 millimeters or more.
Complications of Pregnancy
Poorly controlled diabetes before conception and during the first trimester of pregnancy can cause
major birth defects in 5% to 10% of pregnancies and spontaneous abortions in 15% to 20% of
pregnancies.
Poorly controlled diabetes during the second and third trimesters of pregnancy can result in excessively
large babies, posing a risk to the mother and the child.
Other Complications
Uncontrolled diabetes often leads to biochemical imbalances that can cause acute life-threatening
events, such as diabetic ketoacidosis and hyperosmolar (nonketotic) coma.
People with diabetes are more susceptible to many other illnesses and, once they acquire these
illnesses, often have worse prognoses than people without diabetes. For example, they are more likely
to die with pneumonia or influenza than people who do not have diabetes.
(For more information on diabetes, visit the American Diabetes Association website at
www.diabetes.org.)